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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: Coverage and reimbursement of COVID-19 vaccines and vaccine administration, coverage and reimbursement of COVID-19 testing, coverage and reimbursement of services for the treatment and prevention of COVID-19, including conditions that may seriously complicate the treatment of COVID-19.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the pharmacist dispensing fee from $10.48 to $10.77 per prescription.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to waive the requirement (for year 2023) that state notify enrollees, through an annual mailing, that one or more of their healthcare providers are now part of the state's Integrated Health Partnerships (IHP) program (as outlined in approved State Plan Attachments 3.1-A Page 79b2 and Attachment 3.1-B Page 78b2).
Summary: This state plan home and community-based services (HCBS) benefit is Adding a moving expense allowance to Housing Stabilization - Transition Services.
Summary: This amendment preserves approved coverage of prescription drugs, dentures, and prosthetic devices while resolving a technical duplicate page number issue in Attachment 3.1A.
Summary: This SPA adds conforming updates in state law, including commissioner authority to grant variance of behavioral health home service provider requirements; clarification of provider requirements and expectations; corrects the list of qualified positions for a Qualified Health Home Specialist, and adds requirement for Behavioral Health Home (BHH) providers to notify the contact designated by an enrollee’s managed care plan within 30 days of the start of BHH services.
